Tool and method for removing an acetabular ball from an acetabular cup in a hip replacement prosthesis

ABSTRACT

A surgical tool for extracting an acetabular ball from an acetabular cup in an implanted hip prosthesis wherein the from acetabular ball is affixed by means of a Morse taper to a stem extending from bottom of the concave portion of the acetabular cup. The surgical tool enables a surgeon to remove the ball without pulling on the acetabular cup and without disrupting any bone ingrowth because the tool maintains pressure on the cup while exerting an opposing pressure pulling on the ball.

BACKGROUND OF THE INVENTION Field of the Invention

The present invention relates to surgical tools used in connection witha reverse hip prosthesis. More particularly, the invention has to dowith a surgical tool for extracting an acetabular ball from anacetabular cup.

The Related Art

A reverse hip prosthesis is described in U.S. Pat. Nos. 8,313,531 B2 and8,540,779 B2. The prosthesis and a revision surgery method also aredescribed in U.S. Pat. No. 8,992,627 B2. The disclosures of these threepatents are incorporated herein in their entireties by reference.

SUMMARY OF THE INVENTION

As described in the patents referenced above, the acetabular ball isaffixed by means of a Morse taper to an acetabular cup stem. The stemextends from the bottom of a concave surface of the acetabular cup. Thesurgical tool of the invention enables a surgeon to remove theacetabular ball from an implanted prosthesis without pulling on theacetabular cup and without disrupting any bone ingrowth. In the presentdisclosure, we use the term “acetabular ball extractor” from time totime to describe the tool of the invention and the term “tool” or“instrument” is sometimes used to refer to either or both of the firstand second embodiments of the invention.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 is a perspective view of a first embodiment of the surgical toolof the invention.

FIG. 2 is an elevation view of a second embodiment of the tool.

FIG. 3 is a section view of the tool in a first step illustrating thejaws positioned over an acetabular ball which has been affixed in anacetabular cup.

FIG. 4 is an elevation view of the tool in a second step fully engagedwith the acetabular ball and cup.

FIG. 5 is a section view of FIG. 4 taken along section line A-A.

FIG. 6 is a section view of the tool in a third step illustrating anacetabular ball separated from the stem of the acetabular cup.

FIG. 7 is an elevation view of a handle or outer shaft for theacetabular ball extractor.

FIG. 8 is an elevation view of a jaw assembly of the acetabular ballextractor.

FIG. 9 is an elevation view of a block bar of the acetabular ballextractor.

FIG. 10 is an elevation view of the handle bell of the acetabular ballextractor.

FIG. 11 is an elevation view of a shaft nut of the second embodiment ofthe acetabular ball extractor.

FIG. 12 is a partially exploded view of the second embodiment of thetool of the invention.

FIG. 12A is a magnified view of the proximal end of FIG. 12.

DESCRIPTION OF THE PREFERRED EMBODIMENTS

The tool 1 is the first embodiment of the tool of the invention and isillustrated in perspective in FIG. 1. The tool 1 a is the secondembodiment of the tool of the invention and is illustrated in apartially exploded view in FIG. 12 and in elevation in FIG. 2.

Referring to FIGS. 1-6, the tool 1 comprises a jaw shaft 10 having twoor more than two jaws 2 disposed at the distal end thereof. Each jaw 2is pivotable about a pin 12 having an axis perpendicular to a centralaxis of jaw shaft 10. And jaw shaft 10 has a threaded proximal end 11.(See FIGS. 8, 12 and 12A.) The jaw shaft 10 is disposed concentricallyin outer shaft 4. A bell shaped element, referred to herein as handlebell 3, is affixed to the distal end of outer shaft 4. The handle bell 3is internally sized to cause jaws 2 to close as the jaws 2 are drawninto the handle bell 3 by proximal movement of jaw shaft 10 toward theproximal end of the tool 1 as explained in more detail below. The handlebell 3 has a circumferential bell edge 33 at its distal end sized toengage a circumferential cup edge 23 of an acetabular cup. Outer shaft 4has an optional knurled portion 5.

A jaw shaft nut 9 or 9 a is threaded onto the proximal end of jaw shaft10 and an outer shaft nut 6 or 6 a is affixed to the proximal end ofouter shaft 4. When the jaw shaft nut abuts the outer shaft nut and thethreads at the proximal end of shaft 4 are right handed, tightening jawshaft nut 9 or 9 a by turning it in a clockwise (or right-handed)direction will exert a distal force on nut 6 or 6 a causing the jawshaft 10 to move in a proximal direction relative to the outer shaft 4.By way of further explanation, the nuts are disposed adjacent to oneanother with the jaw shaft nut 9 or 9 a being disposed proximally to theouter shaft nut 6 or 6 a. Jaw shaft 10 is illustrated in section inFIGS. 3, 5 and 6, and in elevation in FIG. 8. FIGS. 12 and 12Aillustrate the threaded proximal end 11 of jaw shaft 10; FIG. 12A beinga magnified view of the proximal end A of the tool illustrated in FIG.12. FIG. 7 is an elevation view of outer shaft 4 with an outer shaft nut6 a thereon. The jaw shaft 10 is illustrated in elevation in FIG. 8 withjaws 2 thereon and a block bar 8 is illustrated in elevation in FIG. 9.FIGS. 10 and 11 are elevations of handle bell 3 and jaw shaft nut 9 a,respectively.

The difference between tools 1 and 1 a has to do with differences inouter shaft nuts 6 and 6 a and jaw shaft nuts 9 and 9 a. Nuts 6 and 9are knurled and holes 7 are provided in the knurled portions to receiveblock bars 8 which are used to provide leverage in the operation of thetool. Nuts 6 a and 9 a are also knurled but they are additionallyprovided with hex portions 14 and 15, respectively. Holes 7 a areprovided for block bars 8 in hex portions 14 and 15. The hex portionsallow the surgeon to use a wrench or wrenches (not shown) instead ofsome or all of the block bars in order to obtain increased leverageduring operation of the tool. Of course, flattened portions on the outersurface of the nuts having shapes other than a hex can be used to permituse of a wrench or other tool in order to obtain increased leverage aswill be apparent to those having ordinary skill in the art.

The operation of the tool is illustrated in FIGS. 3-6. The jaws 2 areallowed to open when jaw shaft 10 is pushed in a distal direction whileholding shaft 4 so that the jaws move out of handle bell 3. The jaws 2are hinged by pins 12. In FIG. 3 the jaws 2 are shown in section afterthey have been pushed out of handle bell 3 and pushed over acetabularball 20. Two or more than two jaws may be used as will be apparent tothose having skill in the art. Acetabular ball 20 is securely affixed bymeans of a Morse taper on stem 21. Stem 21 is affixed to and extendsfrom the concave surface off acetabular cup 22.

In FIGS. 4 and 5 the circumferential bell edge 33 at the distal end ofhandle bell 3 has been pushed into engagement with the circumferentialcup edge 23 of acetabular cup 22. When the tool has been engaged withthe ball and cup in this manner, the next step is to grip shaft 4 whileturning jaw shaft nut 9 or 9 a causing the jaw shaft to move in aproximal direction so that jaws 2 pull on acetabular ball 20 whilehandle bell 3 exerts an opposing force on the circumferential cup edge23 of acetabular cup 22. The opposing force prevents pulling onacetabular cup 22 so that the cup is not pulled out of the acetabulum. Arod or block bar 8 is placed in a hole 7 or 7 a of outer shaft nut 6 or6 a and another rod or block bar 8 is placed in a hole 7 or 7 a of jawshaft nut 9 or 9 a when additional leverage is needed to exert a pullingforce on acetabular ball 20 and an opposing pushing force on acetabularcup 22. The holes 7 and 7 a are perpendicular to the central axes of thenuts. If more leverage is needed, the block bars 8 are removed from oneor both of shaft nuts 6 a or 9 a and a wrench is used on either or bothshaft nuts by placing the open end of the wrench(es) (not shown) overone or both hex portions 14 or 15. When sufficient force is exerted, theball separates from stem 21 as illustrated by space 30 in FIG. 6.

1. (canceled)
 2. (canceled)
 3. (canceled)
 4. (canceled)
 5. (canceled) 6.(canceled)
 7. (canceled)
 8. A surgical tool comprising: a jaw shaft atleast two jaws disposed at a distal end thereof, each jaw having acurved inner surface which at least partially abuts against thegenerally spherical surface of an acetabular ball affixed by means of astem extending from a concave surface of an acetabular cup having acircumferential cup edge, each of the jaws being pivotable about an axisperpendicular to a central axis of the jaw shaft and the jaw shaftfurther having a threaded proximal end; an outer shaft into which thejaw shaft is concentrically disposed, the outer shaft having a bellshaped handle bell affixed to a distal end thereof, the handle bellhaving a circumferential bell edge surrounding an opening at a distalend of the handle bell, the circumferential bell edge sized to engageagainst the circumferential cup edge, the handle bell being internallysized to cause the jaws to close and engage the curved surface of theacetabular ball against at least a part of the curved inner surfaces ofthe jaws while at the same time the handle bell separates the jaws fromthe concave surface of the acetabular cup after the jaws are drawn intothe handle bell by proximal movement of the jaw shaft toward a proximalend of the surgical tool and, the circumferential bell edge is engagedagainst the circumferential cup edge of the acetabular cup; an outershaft nut affixed to the proximal end of the outer shaft, the jaw shaftnut and the outer shaft nut being disposed adjacent to one another andthe jaw shaft nut being disposed proximally to the outer shaft nut; ajaw shaft nut threaded onto the proximal end of the jaw shaft whereintightening of the nut exerts pressure in a distal direction on theproximal end of the outer shaft causing the jaw shaft to move proximallyrelative to the outer shaft and thereby causing the jaws to engage thecurved inner surfaces of the jaws with the curved surface of theacetabular ball while the jaws exert a pulling force on the acetabularball while causing the circumferential bell edge of the handle bell toexert an opposing force on the circumferential cup edge of theacetabular cup and to separate the jaws from the concave surface of theacetabular cup, until sufficient tightening of the jaw shaft nut causesthe acetabular ball to be released from the stem and the acetabular ballis retained in the jaws until the jaw shaft nut is sufficiently loosenedwith respect to the jaw shaft to permit for the jaws to release theacetabular ball from within the curved inner surfaces of the jaws. 9.The surgical tool of claim 8 wherein the jaw shaft nut and the outershaft nut each further comprise a hole perpendicular to the central axisthereof, each hole being sized to receive a rod wherein the rod providesleverage for turning the jaw shaft nut relative to the outer shaft nut.10. The surgical tool of claim 8 wherein one or both of the jaw shaftnut and the outer shaft nut further comprise flattened portions on theouter surface thereof to facilitate engagement of a wrench or other toolto provide increased leverage.
 11. The surgical tool of claim 8, whereina portion of the outer shaft is knurled.
 12. The surgical tool of claim8, which includes at least one block bar which is engageable with thejaw shaft nut.
 13. The surgical tool of claim 8, which includes at leastone block bar which is engageable with the outer shaft nut.
 14. Thesurgical tool of claim 8, which includes: at least one block bar whichis engageable with the jaw shaft nut; and, at least one block bar whichis engageable with the outer shaft nut.
 15. A kit comprising: thesurgical tool of claim
 8. 16. A method of using the surgical tool ofclaim 8 in separating an acetabular ball which affixed by means of astem extending from a concave surface of the acetabular cup, the methodcomprising the steps of: disposing the jaws over the acetabular ballaffixed by means of a Morse taper to a stem extending from a concavesurface of the acetabular cup and contacting the circumferential belledge of the bell shaped element with the circumferential cup edge of theacetabular cup; and, pulling the jaw stem in the proximal directionwhile pushing on the acetabular cup in a distal direction until theacetabular ball is released from the stem.
 17. The method of claim 6wherein: the jaw stem is pulled in the proximal direction while pushingon the acetabular cup in a distal direction by tightening of the jawshaft nut.
 18. The method of claim 16, wherein the stem comprises aMorse taper.